One of the key areas of DBT focuses on distress tolerance—the ability to cope with difficult emotions without letting them spiral out of control. But how do these skills actually work with our nervous system to help us stay grounded? Let’s explore how DBT distress tolerance skills can help regulate the body and why they work. In order to do this we must first understand what’s happening in our body when emotions run high.
When we experience overwhelming emotions, our nervous system kicks into action. The body can activate the fight-or-flight response, flooding us with adrenaline and cortisol—stress hormones that are helpful in dangerous situations but can leave us feeling tense, anxious, or even out of control. This response is essential for survival but can be problematic when it’s triggered by everyday stressors.
When emotions aren’t properly regulated, emotional dysregulation can occur. This means our emotions become so intense that they interfere with our ability to think clearly, make decisions, and handle situations in a healthy way. Without the right tools, we may react impulsively, lash out, or shut down.
That’s where DBT’s distress tolerance skills come in. These skills are designed to help us manage these overwhelming emotions and bring our nervous system back into balance.
How DBT Skills Help Regulate the Nervous System
DBT teaches several practical techniques for managing distressing moments. These tools work by helping us interrupt the body’s automatic stress response, reorient our thoughts, and restore a sense of calm and control. Here’s how two key distress tolerance skills work with our nervous system:
TIP Skills: Temperature, Intense Exercise, Paced Breathing, and Progressive Muscle Relaxation
The TIP skills are designed to quickly change the physiological state of the body, essentially “hitting reset” on the nervous system. Each technique has a unique way of shifting the body out of a heightened state of arousal.
- Temperature: The simple act of changing your body’s temperature can help reset your nervous system. Splashing your face with cold water, holding an ice cube, or even stepping outside into the fresh air can stimulate the body’s vagus nerve, which plays a critical role in calming the body’s stress response. This rapid shift in temperature helps signal the body that the danger (whether real or perceived) is over, triggering the relaxation response.
- Intense Exercise: Engaging in quick, intense physical activity can release pent-up energy, reduce adrenaline levels, and lower cortisol. When we exert our bodies in a controlled way, we send signals to our brain that we are in control, helping to calm the nervous system.
- Paced Breathing: Deep, slow breathing activates the parasympathetic nervous system (the “rest and digest” system), which helps calm the body. By focusing on breathing deeply and slowly, we can reduce the intensity of physical symptoms associated with emotional overwhelm, such as a racing heart or shortness of breath.
- Paired Muscle Relaxation: This technique involves tensing and then releasing each muscle group in the body. By doing this, we can reduce physical tension and bring the nervous system back into balance, allowing us to regain control over our emotional state.
Why These Skills Work
DBT distress tolerance skills work by helping individuals regulate their nervous system and manage emotional overwhelm. These skills don’t necessarily eliminate the stressor, but they help you control your body’s reaction to it. They focus on giving you tools to interrupt the automatic stress response and bring you back into a state of balance.
The beauty of DBT lies in its practicality—these are skills that can be used in real-time when emotions are high. Whether you’re feeling angry, anxious, or panicked, these techniques help you stay grounded, calm, and in control. By practicing these skills regularly, you’ll train your body and mind to handle distressing situations with more ease, reducing the impact of emotional dysregulation on your life.
